Joel jogs through the atrium on the way to work, cutting the line at the coffee kiosk. Standing on line with Gavin, Maggie is outraged and says so - what makes Joel so special!? Afterwards, she asks Gavin if he can tell that she has a crazy crush on Joel. Alex wakes up in a chair next to Charlie's bed in the ICU and gives him a loving kiss good morning. She gets right to work switching out Charlie's IV bag, as the tuxedo-clad Charlie remarks on the difficulty of being both in a coma and having an out-of-body experience: he's screwed both ways. Melanda pops her head in the room to check on Alex, advising her to let people be nice to her. Alex warns Melanda not to make her cry because if she starts, she won't be able to stop. When ICU nurse Jackson reminds Alex she's late for the OR, she runs off.
Intimidating Dana Kinney isn't happy to be interim Chief of Surgery while Charlie's in a coma, but she fully expects him to wake up. Of course, if there are no changes in Charlie's condition in three weeks, then Alex will know she's up a creek. Dana's none too happy with Alex's tardiness either. In fact, she's assigned Tom Reycraft to perform the surgery on Alex's patient along with cocky nurse Victor Reis. Alex may be chief surgical resident, but Kinney is damn sure not going to give her special privileges like Charlie did. Joel heads to the ER for a consult with handsome ER doctor Zach Miller. Kym Spence fell off her bike and broke her tibia so badly it's sticking out of her shin. Kym's husband Aaron immediately requests a female doctor; he doesn't want Joel to touch Kym. But Kym is in so much pain she can barely speak, and it's not her leg; it's her shoulder. Joel schedules some tests and sets up a consult with a general surgeon.
Alex checks out 12-year-old Cal. Pediatrician Lisa Rundle reports that this is Cal's third trip to Hope-Zee this month for diarrhea and abdominal pain. Just as Alex orders an MRI, Cal freaks out, screams, "Stop touching me!" and bites down hard on Lisa's arm. Gavin offers to do a psych consult, but Lisa thinks she has Cal's number: his parents are getting divorced, so he's loco. Alex continues to ICU, where she's stunned to find a woman in Charlie's room. It's cardiologist Dawn Bell, Charlie's superhot, super-smart ex-wife. Devastated, Dawn gives Alex an awkward hug, then lays into her for changing Charlie's IV - this is the kind of thing nurses do. And why hasn't Charlie been started on coma arousal therapy - or any other alternative treatments for that matter? Alex assures her the alternatives are unproven and the staff is doing everything they can. Dawn wonders why Alex won't consider trying all the alternatives - Dawn sure would. In spirit form, Charlie remarks that Alex has her second opinion, whether she asked for it or not.
Maggie shows up to consult on Kym, introducing herself to Joel and reminding him of the morning's coffee incident. She thinks Kym has a ruptured spleen - her shoulder pain is a common symptom called Keyr's sign. Since they'll have to set her leg before dealing with the spleen, Joel calls for morphine, but Kym firmly refuses any drugs. The next step will involve surgery to remove Kym's spleen - a splenectomy. When Aaron learns the surgery will involve a blood transfusion, he refuses consent. The couple's religion forbids blood transfusions. Alex finds Cal in the atrium, waiting for his dad to pick him up. Just before passing out and falling to the floor, Cal admits that doesn't feel any better. And in fact - he's code blue! Alex immediately starts CPR on the gurney as Cal is wheeled into the ER. Charlie is shocked to find he has a new friend, as both he and Cal watch Alex, Zach and the ER doctors bring Cal back to life.
After performing an ultrasound on Kym, Maggie defers judgment to a senior surgeon. Aaron's hoping a clotting agent will help, but Maggie knows Kym needs surgery or she'll die. While loitering in the waiting room, Charlie is stunned to hear his favorite song. He walks through the hospital trying to figure out where the music is coming from. Just as he rounds the corner to ICU, Alex is stunned to find Dawn sitting on Charlie's bed massaging him and pumping his favorite song through headphones. Coma arousal therapy must begin within 72 hours of injury or it won't work. Annoyed, Alex removes the headphones and asks Dawn to stop touching Charlie. Dawn claims someone has to touch Charlie; what is Alex doing for him as his wife? Alex points out that she's Charlie's fiancee. Dawn reminds Alex that the Charlie she knows would rather die than be in the position he's in now.
Maggie busts into Joel's OR to report on Kym. Her spleen is shattered and she only has an hour and a half before she bleeds out completely. All Joel will recommend is keeping Kym comfortable; they can't force her to consent to surgery. When Maggie suggests consulting the hospital ethicist, Joel scoffs. What - are they going to bore Kym into having surgery? Disgusted, Maggie turns on her heel and leaves. While examining Cal, Alex tells his parents she needs to do exploratory surgery around his bowel to identify his problem. It's not long before the couple starts arguing and Cal starts crashing - again. Alex asks Victor to get Cal's parents out of the room and yells for the crash cart.
Once again, Charlie is on hand to school Cal in the dynamics of their mutual state of limbo. Since neither one of them is dead, they decide to take a walk. Charlie explains that he's in a coma; and in his experience, dead people don't stick around for very long, and he's not sure where they go. Even though he doesn't feel like he's dead, Cal panics. Charlie assures him that he's already come back from the dead once and takes Cal to the morgue to view an actual dead body. Charlie asks Cal about his symptoms: stomachaches, diarrhea and biting doctors. And then there's the divorce. Charlie assures Cal that he's not at the root of his parents' situation. When Cal starts flushing, Charlie knows what's wrong with him - which is just when Cal revives. Alex notices the flushing and diagnoses carcinoid syndrome.
Maggie drags Joel to the ER to talk to Kym, who's in terrible shape. Having lost of her blood, she's in hypovolemic shock. When Kym clutches Aaron to scream that she's dying and begs to get up, Aaron finally cracks. Joel confirms that Kym is in fact dying, so Aaron kisses her and sends her off to surgery. Meanwhile, Alex gives Cal's parents the good and bad news. Carcinoid tumors secrete hormones and have made Cal's system go crazy, causing all his erratic symptoms. Now they just have to operate to remove the tumors. When Cal's dad Paul looks for a reason why, Alex assures them that none of this is their fault.
While scrubbing in, Maggie remarks that Joel always knew Aaron wouldn't let Kym die. She's not sure whether Joel is insane or a genius, and while he sickens her, she can't help being totally turned on. Joel claims Maggie's crush makes him uncomfortable, so she clarifies: she doesn't have a crush on him, but she'd do him. Maggie steps into the OR, leaving a stunned Joel to welcome Reycraft to surgery. Reycraft is to let Maggie do the splenectomy while Joel supervises - she earned it. Later, Alex stops by Shahir's office to confirm they're doing everything they can for Charlie. Shahir thinks all the therapies mentioned by Dawn are poppycock. Dawn's a cardiologist; she doesn't know anything about neuro. The reason Charlie isn't waking up? Comas are mysterious. And furthermore, Alex should be careful of Dawn. Alex isn't married to Charlie, but she should become his legal decision maker, in case things drag on.
Joel and Reycraft are on hand to guide Maggie through her first splenectomy. Not surprisingly, she continues her seduction of Joel while she's knee-deep in spleen. In a neighboring OR, Alex operates on Cal, who crashes for the third time. This time, Charlie is prepared, asking Cal to give Alex the message that he loves her. A few seconds later, Cal's normal sinus rhythm returns. After the surgery, Alex checks in with Dana - are they going to have a problem? Alex didn't get the job of chief surgical resident because of Charlie - she earned it - and she doesn't need special treatment, but she does need Dana's respect. Later, Alex tells Cal the good news that she was able to remove all his tumors. Cal is drawing a picture of his surgery: he's on the table, while a guy in a tux stands by. Cal knows that the guy isn't his dad, but he can't quite remember the name of the guy wearing the bow tie. Touched in more ways than one, Alex asks Cal if she can keep his drawing.
Late that evening, Maggie pulls Joel into an empty room. Joel thinks whatever Maggie has in mind is a bad idea, and he's not up for a relationship; so she pulls off her shirt and tells him to shut up. And no, the door doesn't lock. Melanda finds Alex at Charlie's bedside. Feeling tentative, Alex shows Melanda Cal's drawing - is it Charlie's ghost that Cal somehow sensed while he was anesthetized? Melanda's not buying it - Charlie's no ghost; he's not dead. Refusing to join Melanda for a glass of wine, Alex pulls out her phone and plays a song for Charlie, which brings back a memory for both of them from a year earlier: Lost on a country road, they say "I love you" for the first time. Charlie muses that human contact is bigger than any idea, more comforting than words. Without it, we die. Alex looks down, stunned to see Charlie's hand moving.